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虚拟服务在情绪、焦虑和情感联系方面是否等效?对一项围产期强化门诊项目的研究。

Are virtual services equivalent for mood, anxiety, and bonding? examining a perinatal intensive outpatient program.

作者信息

Cherry Kathryn E, Li Jenna D, Brent Rebecca J

机构信息

Women's Behavioral Health, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA, 15224, USA.

Allegheny Singer Research Institute, Allegheny Health Network, Pittsburgh, PA, 15224, USA.

出版信息

Arch Womens Ment Health. 2025 Feb;28(1):147-155. doi: 10.1007/s00737-024-01480-y. Epub 2024 Jun 10.

Abstract

PURPOSE

Perinatal Intensive Outpatient Programs (IOPs) address severe perinatal mood and anxiety disorders (PMADs) and mother-infant relationship concerns. Given the impact of PMADs on mothers and infants, rapid transitions to virtual services (telehealth) amid COVID-19, and service expansions to populations in need, it is critical to evaluate how effectively virtual and in-person perinatal IOP services treat PMADs and mother-infant bonding.

METHODS

This quality-improvement record review examined patient records (n = 361) for a perinatal IOP from May 2016 to July 2023, amid multiple transitions between in-person and virtual services related to COVID-19, influenza, and respiratory syncytial virus. Patients in the completed measures sample (n = 115) completed depression (EPDS), anxiety (GAD-7, PASS), and mother-infant bonding (PBQ) measures over the first 3 weeks of treatment. Patients also anonymously provided program satisfaction ratings and qualitative feedback.

RESULTS

While anxiety and depression symptoms improved similarly across service settings, mother-baby bonding only significantly improved with in-person treatment. Patient symptom outcomes also differed by public/private insurance, race, and number of children. Patients reported high service ratings and overall satisfaction, and available feedback indicates some preference for in-person services.

CONCLUSION

As perinatal mental health services and IOPs continue to expand, virtual services can similarly address anxiety and depression symptoms and help to reach in-need populations. However, for perinatal IOPs, the core treatment target of mother-infant bonding may be uniquely addressed via in-person services.

摘要

目的

围产期强化门诊项目(IOPs)针对严重的围产期情绪和焦虑障碍(PMADs)以及母婴关系问题。鉴于PMADs对母亲和婴儿的影响、在新冠疫情期间迅速转向虚拟服务(远程医疗)以及向有需要的人群扩大服务范围,评估虚拟和面对面的围产期IOP服务治疗PMADs和母婴联结的效果至关重要。

方法

这项质量改进记录审查检查了2016年5月至2023年7月期间一个围产期IOP的患者记录(n = 361),在此期间与新冠疫情、流感和呼吸道合胞病毒相关的面对面和虚拟服务之间多次转换。完成测量样本中的患者(n = 115)在治疗的前3周完成了抑郁(爱丁堡产后抑郁量表)、焦虑(广泛性焦虑障碍量表、产后焦虑筛查量表)和母婴联结(产后母婴联结问卷)测量。患者还匿名提供了项目满意度评分和定性反馈。

结果

虽然焦虑和抑郁症状在不同服务环境中改善情况相似,但母婴联结仅在面对面治疗时显著改善。患者症状结果也因公共/私人保险、种族和子女数量而有所不同。患者对服务给予了高评分和总体满意度,现有反馈表明有些患者更倾向于面对面服务。

结论

随着围产期心理健康服务和IOPs不断扩大,虚拟服务同样可以解决焦虑和抑郁症状,并有助于覆盖有需要的人群。然而,对于围产期IOPs,母婴联结这一核心治疗目标可能需要通过面对面服务来独特地实现。

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